HospitalInspections.org

Based on medical record review, facility policy review and staff interview the Critical Access Hospital (CAH) failed to ensure a comprehensive assessment after day 14 of their stay for 3 of 3 swing bed patients (Patients 32, 34 and 36) and a discharge summary that included a recapitulation of the patients stay for 4 of 5 swing bed patients (Patients 32, 33, 34 and 36). This failed practice had the potential to affect all swing bed patients at the CAH. The number of swing bed patients at the CAH for Fiscal Year 2024 was 62.

Findings are:

A. Review of Patient 32's medical record (3/13/25 at 8:00AM) revealed a swing bed admission of 12/18/24 - 1/14/25 for pneumonia. Review of the entire medical record revealed a lack of evidence of a comprehensive assessment within 14 calendar days after admission and evidence of a discharge summary that included a recapitulation of the patients stay.
- Review of Patient 33's medical record (3/13/25 at 8:20AM) revealed a swing bed admission of 1/21/25 - 1/28/25 for cellulitis of the right lower leg. Review of the entire medical record revealed a lack of evidence of a discharge summary that included a recapitulation of the patients stay.
- Review of Patient 34's medical record (3/13/25 at 10:00AM) revealed a swing bed admission of 8/29/24 - 9/13/24 for sepsis. Review of the entire medical record revealed a lack of evidence of a comprehensive assessment within 14 calendar days after admission and evidence of a discharge summary that included a recapitulation of the patients stay.
- Review of Patient 35's medical record (3/13/25 at 10:30AM) revealed a swing bed admission of 2/26/25 - 3/13/25 for endocarditis and osteomyelitis. Review of the entire medical record revealed a lack of evidence of a discharge summary that included a recapitulation of the patients stay.
- Review of Patient 36's medical record (3/13/25 at 11:05AM) revealed a swing bed admission of 10/9/24 - 11/4/24 for an open wound of their left lower leg. Review of the entire medical record revealed a lack of evidence of a comprehensive assessment within 14 calendar days after admission and evidence of a discharge summary that included a recapitulation of the patients stay.

B. Review of facility policy Scope Of Services Level Of Care Provided in Skilled Care Swing Beds, last revised 9/2024 revealed, all swing bed patients will have a discharge summary that includes the following information: Summary (recapitulation) of the patients stay. A final summary of the patient status at the time of discharge is available to authorized persons and agencies with the consent of the patient or their legal representative. A post discharge plan of care that is developed with the participation of the patient and his or her family, which wi9ll assist the patient to adjust to his or her living environment. The policy lacks information regarding a comprehensive assessment being completed within 14 days of admission to swing bed.

C. Interview with Quality RN (3/13/25 at 11:55) confirmed the above medical records lacked evidence of comprehensive assessment and a discharge summary with a recapitulation of the patients stay.

D. Interview with Care Manager (3/13/25 at 11:15AM) revealed that the CAH uses the providers discharge summary note as the recapitulation of the patients stay.